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      Expert Consensus on the Clinical Use of Pulse Wave Velocity in Asia


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          Arterial stiffness is a progressive aging process that predicts cardiovascular disease. Pulse wave velocity (PWV) has emerged as a noninvasive, valid, and reliable measure of arterial stiffness and an independent risk predictor for adverse outcomes. However, up to now, PWV measurement has mostly been used as a tool for risk prediction and has not been widely used in clinical practice. This consensus paper aims to discuss multiple PWV measurements currently available in Asia and to provide evidence-based assessment together with recommendations on the clinical use of PWV. For the methodology, PWV measurement including the central elastic artery is essential and measurements including both the central elastic and peripheral muscular arteries, such as brachial-ankle PWV and cardio-ankle vascular index, can be a good alternative. As Asian populations are rapidly aging, timely detection and intervention of “early vascular aging” in terms of abnormally high PWV values are recommended. More evidence is needed to determine if a PWV-guided therapeutic approach will be beneficial to the prevention of cardiovascular diseases beyond current strategies. Large-scale randomized controlled intervention studies are needed to guide clinicians.

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          Most cited references146

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          2018 ESC/ESH Guidelines for the management of arterial hypertension

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            2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults

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              Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis.

              The purpose of this study was to calculate robust quantitative estimates of the predictive value of aortic pulse wave velocity (PWV) for future cardiovascular (CV) events and all-cause mortality by meta-analyses of longitudinal studies. Arterial stiffness is increasingly recognized as a surrogate end point for CV disease. We performed a meta-analysis of 17 longitudinal studies that evaluated aortic PWV and followed up 15,877 subjects for a mean of 7.7 years. The pooled relative risk (RR) of clinical events increased in a stepwise, linear-like fashion from the first to the third tertile of aortic PWV. The pooled RRs of total CV events, CV mortality, and all-cause mortality were 2.26 (95% confidence interval: 1.89 to 2.70, 14 studies), 2.02 (95% confidence interval: 1.68 to 2.42, 10 studies), and 1.90 (95% confidence interval: 1.61 to 2.24, 11 studies), respectively, for high versus low aortic PWV subjects. For total CV events and CV mortality, the RR was significantly higher in high baseline risk groups (coronary artery disease, renal disease, hypertension) compared with low-risk subjects (general population). An increase in aortic PWV by 1 m/s corresponded to an age-, sex-, and risk factor-adjusted risk increase of 14%, 15%, and 15% in total CV events, CV mortality, and all-cause mortality, respectively. An increase in aortic PWV by 1 SD was associated with respective increases of 47%, 47%, and 42%. Aortic stiffness expressed as aortic PWV is a strong predictor of future CV events and all-cause mortality. The predictive ability of arterial stiffness is higher in subjects with a higher baseline CV risk.

                Author and article information

                Pulse (Basel)
                Pulse (Basel)
                S. Karger AG (Allschwilerstrasse 10, P.O. Box · Postfach · Case postale, CH–4009, Basel, Switzerland · Schweiz · Suisse, Phone: +41 61 306 11 11, Fax: +41 61 306 12 34, karger@karger.com )
                December 2022
                22 November 2022
                22 November 2022
                : 10
                : 1-4
                : 1-18
                [1] aJB Lab and Clinic, And Department of Precision Medicine and Biostatistics, Yonsei University, Wonju College of Medicine, Seoul, Republic of Korea
                [2] bMenzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
                [3] cShanghai Institute of Hypertension, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
                [4] dResearch Center for Lifestyle-related Disease, Tohoku Rosai Hospital, Sendai, Japan
                [5] eResearch Center, Seijinkai, Mihama Hospital, Chiba, Japan
                [6] fDepartment of Medicine, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
                [7] gDepartment of Sport Science, University of Seoul, Seoul, Republic of Korea
                [8] hDepartment of Cardiology, Tokyo Medical University, Tokyo, Japan
                [9] iUniversité Paris Cité, INSERM, PARCC, Paris, France
                [10] jPharmacology Unit, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
                [11] kDepartment of Biomedical Engineering, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
                [12] lMacquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
                [13] mDepartment of Medicine, Jichi Medical University School of Medicine (JMU), Shimotsuke, Japan
                [14] nDepartment of Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
                [15] oDivision of Faculty Development, Taipei Veterans General Hospital, Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University, College of Medicine, Taipei, Taiwan
                [16] pDepartment of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, California, USA
                [17] qDepartment of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
                [18] rMacquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia
                Author notes
                Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel

                This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission.

                : 9 November 2022
                : 10 November 2022
                : 2022
                Page count
                Figures: 5, Tables: 1, References: 131, Pages: 18
                The authors received no financial support for the research, authorship, and/or publication of this article.
                Medical Consensus

                arterial stiffness,pulse wave velocity,cardiovascular disease,asia


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